Open prostatectomy takes place under general anesthesia with the patient positioned on his back at an incline. The surgeon makes a single incision approximately 4 to 5 inches long. For the most part, the critical structures in and around the prostate can be readily seen.
If magnification is required, the surgeon can use a simple devise called a surgical loupe to enhance his or her view. Once the prostate area is exposed, the surgeon detaches the prostate gland from the urinary bladder and the urethra.
The goal is to remove tissue in a way that eliminates the cancer but minimizes damage to critical surrounding structure — the muscles that control urinary continence and the nerve that enables erectile function.
Once the prostate is removed, the resected end of the urethra is attached to the neck of the bladder see above for information about the IVUA technique.
A Foley catheter is left in place to enable urine to drain during the healing process. The patient is then taken to the Post-Anesthesia Care Unit where he awakes from anesthesia. Following surgery, most men spend one to two days in the hospital. Patients typically receive intravenous IV pain medication during their first day after surgery post-op , then transition to oral pain medications by the second day. Once pain is under control and bowel function has begun to return, the patient is ready for discharge.
After discharge, patients are able to walk. The only restriction is to avoid anything that causes strenuous physical exertion to the lower abdomen. Patients may shower, but they should avoid bathing or swimming. Most patients can return to work approximately 3 to 4 weeks after surgery, provided it does not include anything physically strenuous. Heavy lifting should be avoided for about 6 weeks following the surgery. Following a prostatectomy, the removed tissue is sent to a pathologist for careful evaluation.
The surgeon reviews the pathology report with the patient during the first post-op visit. Based on the pathology results, the patient may need additional treatment such as drug or radiation therapy. Patients have the opportunity to discuss suggested treatment alternatives with a full range of physician experts. Most patients require long-term monitoring of the PSA level to help detect any return of cancer.
The first PSA test occurs 3 months after surgery. Subsequent tests take place every 6 months for a minimum of 5 years.
In addition, patients have regular follow-up appointments with the surgeon for several months after surgery. One of the goals of follow-up care is to help reestablish urinary continence and sexual function. The Prostate and Urologic Cancer Program provides patients with a range of therapies and resources to help them achieve these goals. Skip to main content. Open Prostatectomy for Prostate Cancer. Cancer Services. Less Time Under Anesthesia with Open Prostatectomy An open prostatectomy, however, is a much shorter surgery than the robotic procedure, which means patients spend less time under anesthesia.
Advantages of Open Prostatectomy No therapy is right for every patient. Tactile Input While the robotic surgery system provides excellent visualization of the surgical site, it does not allow the surgeon to touch the prostate gland and surrounding structures. Cancer Control One question that has not yet been resolved is how open prostatectomy and robotic prostatectomy compare with regard to successful cancer treatment.
Lower Risk of Bladder Neck Contracture When the prostate gland is removed in either an open or a robotic prostatectomy , the urinary tract must be put back together by sewing the urethra the tube through which urine passes out the body to the bladder. No Risk of Abdominal Complications In a robotic prostatectomy, the prostate area is accessed through the abdominal cavity.
The Procedure Open prostatectomy takes place under general anesthesia with the patient positioned on his back at an incline. What to Expect After Surgery Following surgery, most men spend one to two days in the hospital.
Post-Operative Care After discharge, patients are able to walk. After the operation, the catheter will drain the urine. It is also used to continuously flush your bladder and Urethra The urethra is the tube that allows urine to pass out of the body. In men, it's a long tube that runs through the penis.
It also carries semen in men. In women, the urethra is short and is located just above the vagina. You will need the catheter for several days until the wound is healed and you can urinate on your own. Open prostatectomy is recommended if your prostate is larger than 80 millilitres because other types of surgery would take more time to achieve the same result.
Your doctor may also recommend open prostatectomy if you have bladder stones or a condition called bladder diverticulum. Your doctor will advise you in detail about how to prepare for the procedure. You must not eat, drink, or smoke for 6 hours before surgery to prepare for the anaesthesia. If you are taking any prescribed medication, discuss it with your doctor. You may need to stop taking it several days before surgery. Usually you can leave the hospital 5 or 7 days after surgery.
The length of hospital stay can vary in different countries. Probably, there will be blood in your urine for several days. You may also suffer from urgency and feel pain when you urinate. It will take several weeks to completely recover from the surgery. Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
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